Corpus of Electronic Texts Edition
A Treatise on Fevers (Author: [unknown])
Section 14
Let it be asked here should blood be let in the {TCD 1299 page and line 32a1} beginning of fevers. It seems it should not on the authority of Avicenna in the first book saying: ‘Phlebotomia ... ’, i . e. the blood should not be let before the digestion of the matter, so it should not be let in the beginning of fevers. Then Galenus says the physician should follow the natural operations, and nature does not expel any part of the illness at its beginning, so the physician should not expel it, as Hippocrates says in this canon: ‘Incipientibus ... ’. Then Avicenna says there are two things preventing the humour-cure and phlebotomy in fevers, i.e. the strength of the unfavourable accidental ailments and the crudeness and thickness of the matter, and it is of the strength of the unfavourable ailments Hippocrates spoke in this canon: ‘Digesta ... ’, so
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either phlebotomy nor humour-cure should be used in the beginning of fevers. Then Avicenna says that one must wait for the digestion of every matter that is in one place before expelling, and the matter of intermittent fever is in one place outside the veins, so blood should not be let in the beginning of these fevers. Then Galenus says in the first book of De Crisi that the cause of ulcers and of fever is the same from the point of view of evacuation, and the matter in an ulcer should not be evacuated till the status, so purgatives should not be given in fever till the matter be digested. Then Galenus says nature should be relieved when it needs relief, and Galenus says nature does not need relief in the beginning of the illness, so blood should not be let in the beginning of fevers. This is opposed in the eighth book of De ingenio sanitatis, for Galenus says one should do all that prepares and hastens the matter towards digestion, and Galenus says phlebotomy in the beginning of fever hastens the matter towards digestion, so phlebotomy is suitable in the beginning of fevers. Then Galenus says in the chapter on sinoca inflatiua that one should not wait for the digestion of the matter nor for the crisis without letting blood, so blood should be let in the beginning of fevers. Then Avicenna says blood should be let when energy is strongest, for the physician should not let blood during weakness of energy, so since there is none of the four periods of the fever in which the energy is stronger than in the beginning, it is then blood should be let. Then Avicenna says that, whenever nature is strong and the matter plentiful, blood should then be let, and the matter is plentiful and nature strong at the beginning of fever, so blood should be let in its beginning. We answer that and say according to Avicenna in the fourth book that there are three classes in which evacuation is given with regard to the cause (or ‘from the vein’), i.e. hora electa expediens et eiroina; hora electa, i.e. the chosen, proper time, and the number of days and the prohibited times should not be examined for this if the energy is strong and the invalid in need of it. Expediens indeed, i.e. when evacuation benefits nature more than it injures it. Eiroina, i.e. when the illness is increased by the evacuation and the natural heat decreased.
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